Vascular ulcers are open sores on the foot or toes caused by poor circulation, often due to vascular disease or diabetes. Treatment can include dressings, medication, or surgery. Compression wraps, blood thinners, and antibiotics may also be used. Severe cases may require surgery to restore blood flow.
A vascular ulcer is a typically painful open sore usually found on the side of the foot or on the toes. These sores can be present in people with moderate to severe vascular disease or diabetes. They can be caused by a minor injury or by continued pressure on areas with poor circulation, such as from shoes that don’t fit well. Treatment of vascular ulcer can involve simple dressings, medications, or even surgery, depending on the severity of the ulcerated tissue.
Most vascular ulcers are caused by poor healing due to insufficient blood circulation due to vascular blockage. When examined by a doctor, it will be difficult to find a pulse in the foot and the skin temperature will be colder than normal. Many people report claudication, or calf pain that increases with physical activity, shortly before the vascular ulcer develops. Bunions and deformed claw-like fingers may also indicate a predilection for ulcer formation.
In many cases, vascular ulcers are slow to heal due to poor blood circulation and the absence of skin tissue cells throughout the wound. Normal wounds generally have skin cells scattered over the wound surface. As the wound heals, these skin cells begin to grow and stick together to form a new layer of healthy skin. The vascular ulcer has only skin cells located around the perimeter of the sore; new skin must grow from the outermost edges of the ulcer and join in the center.
Vascular ulcers can be treated with a combination of therapies. Compression wraps may be recommended to protect raw tissue and promote more efficient blood circulation. Some people with a vascular ulcer take blood thinners or anticoagulant medications daily to prevent blood clots from forming near the ulcerated tissue. Blood thinners can also help the ulcer heal as blood circulation improves.
Most people with a vascular ulcer are at risk of developing an infection due to the open nature of the sore. Oral antibiotics and a topical antibiotic cream can be used to prevent and treat the infection. Unlike other skin ulcers, vascular ulcers do not need to be debrided as part of the treatment process. Debridement, the removal of dead or damaged tissue, can cause further damage to the surrounding skin, resulting in the spread of the ulcerated sore.
Some people with severe vascular ulcers may require surgery to restore proper blood flow to the area. During venous bypass surgery, the surgeon takes a vein from elsewhere in the body and replaces the defective vein, restoring blood flow. Another procedure used to restore blood flow is called an angioplasty; a small surgical instrument is inserted into the blocked artery and slowly widened until the diameter of the artery increases, allowing more blood flow to the affected tissue.
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